Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.73 / $505.56 / $1,381.80	Facility		$235.73	$505.56	$1,381.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.73 / $235.73 / $693.96	Professional		$235.73	$235.73	$693.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $263.32 / $411.53 / $1,191.21	Facility		$263.32	$411.53	$1,191.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $250.78 / $407.22	Professional		$121.34	$250.78	$407.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $366.77 / $513.48 / $647.55	Facility		$366.77	$513.48	$647.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.35 / $288.27 / $360.34	Professional		$237.35	$288.27	$360.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $250.78 / $263.32 / $553.60	Facility		$250.78	$263.32	$553.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $250.78 / $376.17 / $689.65	Facility		$250.78	$376.17	$689.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.70 / $284.50 / $356.11	Professional		$225.70	$284.50	$356.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $263.32 / $411.53 / $689.65	Facility		$263.32	$411.53	$689.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $188.09 / $250.78 / $676.34	Professional		$188.09	$250.78	$676.34
United Facility/Professional Professional Modifier Low / Median / High Price $89.18 / $105.33 / $250.78	Professional		$89.18	$105.33	$250.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.85 / $112.85 / $129.90	Professional		$112.85	$112.85	$129.90